Vacation House Watch Request

2. FAIRLAWN POLICE DEPARTMENT 
   REQUEST FOR VACATION HOUSE WATCH 

   
   

   FAIRLAWN POLICE DEPARTMENT PROVIDES THIS COURTESY SERVICE TO CHECK YOUR RESIDENCE WHILE YOU ARE AWAY FROM HOME. 

   OUR OFFICERS WILL DO THEIR BEST TO CHECK YOUR PROPERTY DURING THE DURATION OF YOUR ABSENCE. WE CANNOT GUARANTEE A CONSISTENT PATROL SCHEDULE DUE TO VARIABLES SUCH AS CALL VOLUMES AND PRIORITY CALLS FOR SERVICE.

6. HOMEOWNER/REQUESTOR INFORMATION

8. First Name*
9. Last Name*
11. Address of Residence (Add Unit/Apt# If Necessary)*
13. City*
14. State*
15. Zip*
17. Home Phone*
19. Cell Phone, or, Phone Number (You can be reached in case of an emergency)*
21. Email Address

25. LOCAL EMERGENCY CONTACT 

    
    

    WE KINDLY ASK YOU PROVIDE US WITH A LOCAL CONTACT WITH ACCESS AND FAMIALIARITY TO YOUR RESIDENCE IN THE EVENT OF AN EMERGENCY SITUATION OR OTHER SITUATION WE FIND NEEDS IMMEDIATE ATTENTION.

27. First Name*
28. Last Name*
30. Address*
32. City*
33. State*
34. Zip*
36. Home Phone*
38. Cell Phone*
40. Secondary Cell

44. VISITOR/HOUSE-SITTER INFORMATION

    
    

    FILL IN INFORMATION BELOW FOR THOSE WHO MAY BE STOPPING BY TO CHECK ON THE HOME, WATER PLANTS, PERFORM SERVICES, OR FEED ANIMALS.

    IF YOU EXPECT NO ONE TO BE AT THE HOME, PLEASE LEAVE THE FIELDS BLANK OR FILL IN "N/A."

46. First Name
47. Last Name
49. Details of Visit and Vehicle Information
51. First Name
52. Last Name
54. Details of Visit and Vehicle Information

58. DURATION OF PATROL REQUESTED

    
    PLEASE INDICATE BELOW THE DURATION OF YOUR ABSENCE.

60. Leaving On
    Leaving On

    Leaving On
62. Returning Home
    Returning Home

    Returning Home

66. HOME GENERAL INFORMATION

    
    PLEASE ENSURE TO FILL IN THE INFORMATION BELOW TO THE BEST OF YOUR KNOWLEDGE TO AID US IN OUR PATROLS.

68. Is the residence equipped with an alarm system, camera system or other property protection device? (If Yes, please indicate the type and alarm company details.))
70. Will any lights be left on? (If Yes, provide details regarding location, timers, etc.)
72. Will any vehicles be left at the residence? (If yes, please indicate the quantity, color, make, model & location.)
74. Will there be any animals at the location? (If Yes, please indicate what type.)
76. Is this property listed for sale, for rent, or currently vacated entirely?*
    -- Select One --YesNo
78. If the property is for sale, rent, or vacant as indicated above, please provide further information such as realtor information.
80. Are there any other details regarding your property we need to be aware of? Please indicate in the section below.
Leave This Blank:


82. 1. Receive an email copy of this form.
83. Email address

    This field is not part of the form submission.

84. Submit

* indicates a required field